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NPI Code Detail

MEDICARE: LOIS J TALLEY PA

MEDICARE:   LOIS J TALLEY  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant10000303AIN

General Provider Information

NPI Number : 1366621344
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOIS J TALLEY PA
Provider Business Mailing Address
First Line : 1080 N GREEN ST STE 150
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-2419
Country : US
Telephone Number : 317-386-5618
Fax Number : 317-386-5463
Provider Business Practice Location Address
First Line : 1080 N GREEN ST STE 150
Second Line :
City : BROWNSBURG
State : IN
Zip : 46112-2419
Country : US
Telephone Number : 317-386-5618
Fax Number : 317-386-5463
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/26/2007
Last Update Date : 04/02/2024

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Directions to “ LOIS J TALLEY PA” Practice Location

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